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Wandering intravascular air gun BB pellet
Abtin Jafroodifar1, Ryan Thibodeau1, Atin Goel1
1Department of Radiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Radiology Case Reports
|October 22, 2020
Summary
A rare case of a pellet migrating backward from the neck to the liver caused organ damage. This highlights the importance of radiologists considering unusual foreign body migration in pediatric non-powder gun injuries.
Area of Science:
- Pediatric Traumatology
- Radiology
- Vascular Surgery
Background:
- Non-powder gun injuries affect numerous children annually, with a significant proportion resulting in puncture wounds.
- Vascular migration of projectiles (wandering bullets) can lead to downstream organ damage via vascular occlusion, typically traveling forward into the pulmonary venous system.
Observation:
- A 12-year-old female sustained a neck injury from a compressed-air gun pellet.
- The pellet migrated retrogradely from the right internal jugular vein into the hepatic vein.
Findings:
- The retrograde migration caused hepatic venous occlusion and congestion, demonstrating an unusual pathway for projectile travel.
- Radiographic scrutiny is crucial to identify foreign bodies outside the initial injury site.
Implications:
- Radiologists must consider the possibility of retrograde projectile migration, even from the venous system.
- Timely diagnosis and management, potentially involving endovascular or surgical retrieval, are essential for preventing further complications.
